纳米碳甲状旁腺负显影在甲状腺癌手术中的应用分析

Application of Negative Stained Parathyroid in Thyroid Carcinoma Surgery by Using Carbon Nanoparticles

目的:探讨在甲状腺癌手术中采用纳米碳淋巴示踪剂保护甲状旁腺的作用。方法:245例甲状腺癌患者随机均分为常规组和纳米碳组,比较两组中央区淋巴结脂肪组织中误切的甲状旁腺检获情况及术后血钙、甲状旁腺素(PTH)改变情况。结果:纳米碳组一过性低钙血症症状发生率13.33%明显低于常规组32.90%,差异具有统计学意义(P<0.05);纳米碳组永久性低钙血症发生率0,常规组1.29%,差异无统计学意义(P>0.05);纳米碳组PTH暂时性减低发生率11.11%低于常规组29.68%,差异具有统计学意义(P<0.05)。PTH永久性减低纳米碳组未发生,常规组1.29%,差异无统计学意义(P>0.05)。病理检查证实纳米碳组检获误切甲状旁腺率4.44%明显低于常规组12.90%,差异具有统计学意义(P<0.05)。结论:应用纳米碳负显影在甲状腺癌手术中可起到辨认和保护甲状旁腺的作用。

Objective To investigate the role of carbon nanoparticles lymphatic tracer in the protection of parathyroid gland in thyroid carcinoma. Methods 245 cases of thyroid cancer patients were randomly divided into the routine group and carbon nanoparticles group, the mistakenly cut rate of parathyroid, postoperative serum level of calcium and parathyroid hormone（PTH） changes were compared between the two groups Results The transient hypocalcemia occurred in carbon nanoparticles group is 12 cases（12 / 90, 13.33 %）, while in routine group is 51 cases（51/155,32.90 %）, which is statistically significant（χ2= 11.416, P = 0.01 0.05）; permanent hypocalcemia did not occurred in the carbon nanoparticles group, while in the routine group were 2 cases（2/155,1.29 %）, which is no statistical significance. The occurrence of PTH temporarily reduction in carbon nanoparticles group is 10 cases（10 / 90, 11.11 %）, wihle in routine group is 46 cases（46/155 29.68 %）, which is statistically significant（χ2 = 11.131, P = 0.01 0.05）. The PTH permanent reduction did not happened in carbon nanoparticles group, while in routine group is 2 cases（2/155,1.29%）, which is not statistically significant. The mistakenly cut of parathyroid confirmed by inspection is 4 cases in carbon nanoparticles group（ 4/90,4.44 %）and 20 in routine group（20/155 and 12.90 %）, which is statistical significance χ2 = 4.611, P = 0.032 0.05）.Conclusion ：The application of lymphatic mapping to recognize and protect negative stained parathyroid in thyroid carcinoma surgery by using carbon nanoparticles.